Residential Intellectual and Developmental Disability Facilities NAICS 623210

Mar 23, 2026 - Governments Spend Billions On Care

• Federal and state expenditures assisted almost 1 million people with intellectual and developmental disabilities nationwide with support for health care, home and community-based services (HCBS), and other areas and supports during fiscal year (FY) 2023, according to researchers at the University of Kansas Life Span Institute. The federal government spent $60.2 billion, states spent $43 billion, and local programs spent $1.37 billion on programs that help support people with intellectual and developmental disabilities during FY 2023, the most recent year of which data is available. Those totals were a shift from the pre-pandemic 2019 measures, which showed a $53.3 billion federal investment, $38.9 billion at the state level and $1.5 billion in local expenditures. "There is a lot of work that still needs to be done to ensure people with IDD and their families have the supports and services necessary for quality-of-life outcomes," said Shea Tanis, associate research professor at the KU Center on Disabilities and director of the research project.
• Six states have taken measures to offset the cost of Affordable Care Act (ACA) plans after a lapse in federal funding left millions of Americans facing higher premiums, according to Healthinsurance.org. Residential intellectual disability facilities may be negatively impacted if patients refuse services because they cancelled their insurance policies due to affordability issues. California, Colorado, Connecticut, Maryland, Massachusetts, and New Mexico have increased their state-funded ACA subsidies for 2026 in response to the expiration of federal tax credits at the end of 2025. The states "modified or enhanced their programs directly to address the reduction in federal premium subsidies," said Louise Norris, a health policy analyst for Healthinsurance. Nonprofit health group KFF reports that several states, especially those operating what are known as State-Based Marketplaces, have been preparing for the lapse of ACA tax credits for months. New Mexico, for example, will fully offset the loss of the federal tax credits for all residents, including recent immigrants. Ten states offer ACA subsidies but only six have increased them since federal subsidies lapsed.

• Private equity (PE) firms have become dominant players in the market for autism services since the mid-2010s, according to The Center for Economic and Policy Research (CEPR). Some residential intellectual disability facilities provide care for those with autism spectrum disorder. PE firms have bought out many provider organizations across the country and created national chains. The buyout of existing providers does not necessarily lead to the needed expansion of services or the opening of new sites, according to the CEPR. Autism services became a ‘hot market’ for PE acquisitions only after widespread health insurance coverage became available by the mid-2010s, according to the CEPR. This occurred through passage of state health insurance mandates, the Affordable Care Act mandate for coverage in its marketplace health plans, and the Medicaid mandate for coverage in 2014 of medically necessary services in behavioral health, including people with autism. Private equity firms completed 85% of all industry mergers and acquisitions in autism services between 2017 and 2022 – a rate not found in any other segment.
• Residential intellectual and developmental disability facilities increased prices 4.32%% year over year in November 2025, according to the US Bureau of Labor Statistics (BLS). Residential intellectual disability facility industry employment and average wages for nonsupervisory employees increased slightly during the first 11 months of 2025, according to the BLS. Residential intellectual disability facility sales are forecast to grow at a 6.94% compounded annual rate from 2025 to 2029, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.